The present invention relates to an external support device, which is designed to assist in the corrective treatment of bone fractures.
Bone fractures are typically treated by restoring the fractured pieces of bone to their natural positions and maintaining those positions while the bone heals. Briefly, the fractured bone(s) is aligned in good position (also called reduction) and then immobilized with a cast that holds the bones in position and immobilizes the joints above and below the fracture. When the initial post-fracture edema or swelling goes down, the fracture may be placed in a removable brace or orthosis. In cases of complex or open fractures, surgical nails, screws, plates and wires may be used to internally hold the fractured bone together.
The surgical implantation of these internal fixation devices, however, may cause extensive trauma to the patient, increase potential for infection, and require second surgery for their removal. An alternative to internal fixation devices is the external fixation device. Pins or screws are placed into the broken bone above and below the fracture site to reposition and immobilize the bone fragments. The pins or screws are connected to a metal bar or bars outside the skin to form a stabilizing frame that holds the bones in the proper position so they can heal. After an appropriate period of time, the external fixation device is removed.
Orthopedic surgeons generally try to reduce bone fractures in patients under general or local anesthesia to relieve pain and muscle spasm, but because of the compression or overriding of the fracture fragments, it is at times necessary to disengage the fracture fragments as a first step of the reducing process. Therefore, in order to achieve this, orthopedic surgeons can put a longitudinal traction on the upper limb while a colleague holds the patient's arm at a certain degree of flexion, for example, at a ninety-degree flexion of the elbow. This traction disengages the fracture fragments and at this moment the surgeon can attempt to reduce the fracture by gently manipulating the fracture fragments. After this step, the upper limb is immobilized by putting a long arm cast, which is meant to cover the whole upper limb while the elbow is positioned at ninety degrees. The upper arm cast also allows the patient to move all digits freely thus preventing finger stiffness.
In situations where the fracture site is too swollen to put a cast on it; the case is not used in such situations because it would pose a great risk due to the potential for blocking of the blood supply to the forearm and hand. In this situation, the surgeon may decide to use a splint in order to immobilize the arm and wait till the swelling reduces and the limb is ready for casting. After casting, the patient is encouraged to elevate his/her arm to prevent further swelling and continuous active movement of fingers and shoulder joint to prevent stiffness in these joints.
After reduction of the fracture, the orthopedic surgeon orders an x-ray to evaluate fracture reduction because of the risk of displacement due to the decrease in swelling and due to the loss of the cast fitness and collapsing the fracture fragments. This process of obtaining x-rays is typically repeated several times over a period of about one month. Any unacceptable displacement will be reduced again. After three weeks, the chance of fracture fragment displacement is low and after six weeks the surgeon would remove the cast. For non-displaced fractures, immobilization time is even shorter and the cast can be removed after three weeks.
In the above mentioned medical procedures, there is a lack of an adjustable device which can provide proper stabilization of the upper arm, so that the surgeon can work on the fracture fragments as well as perform x-ray on the fracture site in a steady and stable manner.
Hence, there is a long felt but unresolved need in the orthopedic medical community for a fractured arm support device, namely a forearm and wrist fracture table, which can stabilize and fix the upper limb, and at the same time allow the surgeon to distract the fracture fragments in a gradual and gentle manner to reduce the fracture. Further, there is a need in the art for a forearm and wrist fracture table that makes it comfortable for the surgeon to perform x-rays simultaneously to inserting per cutaneous pins into fracture sites to establish better fixation.